Nativ O, Grant C S, Sheps S G, O'Fallon J R, Farrow G M, van Heerden J A, Lieber M M
Department of Urology, Mayo Clinic, Rochester, Minnesota.
J Surg Oncol. 1992 Aug;50(4):258-62. doi: 10.1002/jso.2930500413.
Eighty-eight patients with pheochromocytoma and paraganglioma treated over a 28 year period (1960-1987) were studied. Based on clinical course, they were divided into three prognostic groups: benign (n = 57); multiple (n = 12); and metastatic (n = 19). Using clinical data, histopathologic findings, and tumor nuclear DNA content a prognostic profile for each group was constructed. The following variables were studied: age, familial pheochromocytoma, associated endocrine or neoplastic disorders, number and location of the lesion at diagnosis, size of the tumor, and the nuclear DNA ploidy pattern. Of these prognostic factors the most significant to predict a future malignant clinical course were large size and local tumor extension at time of surgery. Family history of pheochromocytoma, associated endocrine disorders, and young age at presentation predicted multiplicity. Old age, absence of familial pheochromocytoma or related endocrine disorders and DNA diploid tumors seem to be favorable findings. Using these variables in combination may be helpful for early identification of patients with malignant, multiple, or benign pheochromocytoma and paraganglioma.
对1960年至1987年这28年间接受治疗的88例嗜铬细胞瘤和副神经节瘤患者进行了研究。根据临床病程，将他们分为三个预后组：良性（n = 57）；多发（n = 12）；和转移（n = 19）。利用临床数据、组织病理学发现和肿瘤细胞核DNA含量，构建了每组的预后特征。研究了以下变量：年龄、家族性嗜铬细胞瘤、相关内分泌或肿瘤性疾病、诊断时病变的数量和位置、肿瘤大小以及细胞核DNA倍体模式。在这些预后因素中，预测未来恶性临床病程最显著的是手术时肿瘤体积大及局部肿瘤扩展。嗜铬细胞瘤家族史、相关内分泌疾病以及发病时年龄小预示着肿瘤多发。老年、无嗜铬细胞瘤家族史或相关内分泌疾病以及DNA二倍体肿瘤似乎是有利的发现。综合使用这些变量可能有助于早期识别恶性、多发或良性嗜铬细胞瘤和副神经节瘤患者。
